2413 CALIFORNIA ST 2017-04-10 - Laserfiche WebLink

F=CTRICAL PERMIT AP ICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: I �(YLi a /n�l Y V RU BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPE: ❑ SFR-DETACHED --V SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS:_ ❑ COMMERCIAL USE OF BUILDING: SIn le ( �MmSI n ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ ✓/ gv V NUMBER OF DEVICES if low voltage): FIRE ALARM? ❑YES eNO ASSOCIATED BUILDING PERMIT# if applicable): n n ,, n } DESCRIPTION OF WORK: 2_5� Dana �/l� itTg CSI f cw LS t i nsf�_U 2 kaMw)i 6�z t'f'� mv I df N I I(1 a I n 0 a9 YYVmt �iG nol a I, CONTACT INFORMATION OWNER NAME: J OSI l scwj CDk- nTENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET COl�il-�11�h10� (S1, } �J CITY 1 Iyae+ STATE ZIP OWNER PHONE: -7 ZI 6 J„ —OM U OWNE/�Rp(EMAIL:`v CONTRACTOR NAME: Yl �/✓ t/I�I I IInn MI lav J 10. CONTRACTOR ADDRESS: STREET I� r CITY V-��` STATE�i) ZIP CONTRACTOR PHONE: (”12✓)7n - � r CONTRACTOR EMAIL: ( mc'w S /'lL V'1 l t+WLv v I CONTRACTOR LIC.#(REQUIRED): 1 I V�S 1 J �G CITY OF EVERE BUSINESS LIC.#(REQ RED): PRIMARY CONTACT: ❑ OWNER NTRACTOR ❑ OTHER(Please Specify). CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. That/am authorized by the owner of this property to perform the work for which application is made and/ comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE PERMIT# 1� l 1p E W(O- V� OwnerlAuthor zed Agent Signature Date (Revised 10/12/2015)